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Knee pain


Garfield2010
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So i get this pain on the side of my knee. It is almost below the joint where the tendon and the bone comes together.

 

I dont think it is ITB as I have had ITB in the past and stretching helps. No matter what stretching I do, I cannot simulate the pain...

 

It also always starts at around 70km only. I run marathons etc without any issues.

 

As far as I can tell I am pedalling in straight lines etc.........

 

Any suggesations/ideas before I go and see the Doc? I really need to push through until Jan's Ironman after which I can take a few months off....

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Check your saddle height. There should be roughly a 30deg bend in your leg at the bottom of the pedal stroke.

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I dont think it is ITB as I have had ITB in the past and stretching helps. No matter what stretching I do, I cannot simulate the pain...

 

 

 

Once you have inflamed the ITB no amount of stretching will help you. Go and have it seen to, get a doctor/physios opinion.

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Check your saddle height. There should be roughly a 30deg bend in your leg at the bottom of the pedal stroke.

 

Can you please expand on this. Any other ways to check the height? The ankle depends on how much I drop my heel?

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Can you please expand on this. Any other ways to check the height? The ankle depends on how much I drop my heel?

 

You should probably have a proper fitment done to rule out a fitment issue. As a yardstick though, there should be a 30deg bend in your leg with your ankle parallel to the ground.

 

Where do you live? When I lived in jhb I went to mike at SBR sport in sunninghill. He does an awesome fully comprehensive fitment and is very knowledgeable and well priced.

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I live in Cresta.

 

How do you measure the 30 degrees angle?

 

With difficulty.

 

Dude go get a proper setup and then you can eliminate setup being the issue. It will cost you a few bucks but well worth it.

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Sounds very much like ITBS and I believe (having suffered myself) that the only long term solution is to ensure that your bike setup is correct.

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Sounds very much like ITBS and I believe (having suffered myself) that the only long term solution is to ensure that your bike setup is correct.

 

My 2c would be it actually sounds more like a patellar tendinopathy. ITB is generally on the lateral side of the knee whilst PT is more from the inferior pole of the patella to the top of the tibia (shin bone).

 

It's not likely to just go away by itself and, whilst bike setup may be the cause and aggravate it, changing it may not help the problem itself. Changing the fore/aft of your saddle may help.

 

I'd say physio and then Biokinetics. Physio to sort out pain and inflammation, Bio to sort out knee muscle imbalances and biomechanics. If your Bio knows cycling they can check your setup too.

 

PM if you want me to help find someone in your area...

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My 2c would be it actually sounds more like a patellar tendinopathy. ITB is generally on the lateral side of the knee whilst PT is more from the inferior pole of the patella to the top of the tibia (shin bone).

 

It's not likely to just go away by itself and, whilst bike setup may be the cause and aggravate it, changing it may not help the problem itself. Changing the fore/aft of your saddle may help.

 

I'd say physio and then Biokinetics. Physio to sort out pain and inflammation, Bio to sort out knee muscle imbalances and biomechanics. If your Bio knows cycling they can check your setup too.

 

PM if you want me to help find someone in your area...

 

+1

 

I have found that by having a too linear (vertical) hip to bb plumb line, the patellar tendon gets inflamed and painful. By ensuring that the BB sits in front of your hips and therefore having a greater "forward" pedaling action, this can be rectified. You will however need to improve your lumbar flexibility as this position produces a more acute thigh to torso angle.

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Simply put, knee pain of the type you mention, if associated with cycling, is obviously fit related. The causes can be MANY, from saddle height or fore-aft to saddle sizing, biomechanical asymmetries, neural asymmetries, foot asymmetries, cleat angulation or positioning.

 

However, a good fitter will be able to assess this dynamically and be able to rectify it. Obviously, underlying injuries might need to be sorted out first, but if this is becoming chronic, get a fit.

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